Associate Multiple Diagnoses with an Order

You can associate multiple diagnoses code with an order.

1. Open NextGen® Enterprise EHR.
2. Select the Associate Diagnoses link.
   The Associate Multiple Diagnoses to Orders template opens.

   Note:

   • If the order for the diagnostic study is selected but not yet placed, the selected order appears in the gray read-only Order field. The first assessment selected for the order appears in the gray read-only first diagnosis field Dx1, with its code and status, if a status is selected. The Active Diagnoses grid displays all diagnoses active for the patient.
     

   • If the order for the diagnostic study is placed but not processed through Lab/Radiology Order Processing, the order appears in the Diagnostic Orders grid. The Active Diagnoses grid displays all diagnoses active for the patient.
3. For an order that is placed, select the order in the Diagnostic Orders grid.
   The selected order appears in the Order field. The first assessment selected for the order appears in the first diagnosis field Dx1, with its code and status, if a status is selected.
4. To associate an additional assessment to the selected order, do one of the following:
   • Select an assessment from the Active Diagnoses grid.
   • The selected assessment and its code appears in the first empty diagnosis field, starting with Dx2.
   • Select the first empty diagnosis field, starting with Dx2, and select a diagnosis from the diagnosis search window.
   • The selected diagnosis and its code appear in the selected diagnosis field.
5. Select a status for each additional assessment you add, if required.
   You must enter a status whenever you select an assessment if Require Assessment Status is selected in the Assessment section of the Practice Configuration practice template.

   For more information on the Assessment Status practice configuration, go to NextGen Healthcare Success Community, and download the latest Practice Configuration Template User Guide forNextGen®Adaptive Content Engine.

6. If required, check medical necessity and the Advanced Beneficiary Notice (ABN) waiver.
   If your system is configured to enable the medical necessity verification process on the Practice Configuration practice template, the Medical necessity text field and ABN are visible. If patient demographic information includes insurance and region, the application automatically runs a medical necessity check against all of the diagnoses associated with the selected order, and the result appears in the Medical necessity text field.

   For more information on the Medical Necessity practice setting and Medical Necessity, go to NextGen Healthcare Success Community, and download the latest Practice Configuration Template User Guide forNextGen®Adaptive Content Engine and Medical Necessity User Guide forNextGen®Enterprise, respectively.

   1. If the Medical necessity text field displays Medical Necessity Met or Cannot Confirm, ABN is disabled and there is no further action.
      

   2. If the Medical necessity text field displays " Needs Waiver ", then ABN is enabled.
      

   3. Select ABN.
      The Advanced Beneficiary Notice Waiver Required template opens.

      

   4. Select the option for Advanced Beneficiary Notice waiver that applies, and select Add to ABN
      The Advanced Beneficiary Notice Waiver Required template closes.
7. You can select a preferred sort order for all diagnoses associated with the order.
   Before the order is placed, you cannot change the diagnosis that appears in Dx1, but you can sort diagnoses from Dx2 to Dx4. If the order is placed, you can sort all of the diagnoses associated with the order, from Dx1 to Dx4.
   1. Depending on whether the order is placed or not, select the option button for a diagnosis field from Dx1 to Dx4 displaying the diagnosis to move, and select the double arrow to the right of the Status field. (Before placing the order, you cannot change the diagnosis displayed in Dx1.)
      The Dx Order list opens.
   2. Select the number of one of the twelve diagnosis fields to move the diagnosis, its code and status to, from Dx1 to Dx4. (Before placing the order, you cannot change the diagnosis displayed in Dx1.)
      The diagnosis, its code, and status appear in the diagnosis field selected for it to move to. If the selected move-to diagnosis field already contains another diagnosis, that diagnosis, its code, and status exchange places with the diagnosis being moved, and appears in the field that diagnosis is moved from.
8. Select Update.
   The additional diagnoses are associated with the order and appear in the Active Diagnoses grid.
9. When you are finished associating additional diagnoses with orders, select Close.
   The Associate Diagnoses template closes and you are returned to your workflow on the template you came from.